Download PDF of Course - Spiritual Competency Resource Center

Course Description
This course explores the recovery model, its origins in the consumer movement, and its
connection with spirituality. Mental health systems in this country are undergoing a quiet
revolution. Ex-patients and other advocates are working with mental health providers and
government agencies to incorporate spirituality into mental health care. While the
significance of spirituality in substance abuse treatment has been acknowledged for many
years due to widespread acceptance of 12-step programs, this is a new development in the
treatment of serious mental disorders such as bipolar disorder and schizophrenia. Three
dimensions of this new respect for the importance of spirituality will be addressed:
Many patients and their relatives experience recovery from an episode of mental disorder
as part of their spiritual journey (Lesson )
Patients with mental disorders have genuine religious experiences (Lesson )
Patients with mental disorders benefit from spiritual support (Lesson )
Course Objectives
After completing this course, the participating clinician will be better equipped to:
1.conduct a spiritual assessment
2. develop treatment approaches for persons with mental disorders that are sensitive to
their spiritual issues and background
3. incorporate spiritual interventions in appropriate situations
4.conduct searches on the Internet for the latest research and clinical articles on recovery
5.describe and understand the role of the consumer movement in the recovey model
6. Demonstrate mastery of the knowledge and Internet search skills required to achieve
objectives 1-5 by completing the quiz and quest exercises to a criterion of 75% for CE
credit.
Instructions for Taking This Course
The lessons for this course are online through Blackboard. Most of your course time will
be spent visiting sites on the World Wide Web, a part of the Internet. It is recommended
that you print the entire course or individual lessons for easier reading, and then go back
online to visit the links. None of the sites in this course charge for using their resources.
Instructions for CE credit
Collecting CE requires filling out the CE Quiz Form and paying the tuition fee of $89.
You can register and fill out the Online CE Quiz Form (includes a secure form for credit
card payment). Or you an print out the Online CE Quiz Form and fill it in as you work
your way through the course. Then mail or fax it to Internet Guided Learning
(instructions are on the form). Include the tuition fee of $89 by check or credit card
number. Your certificate awarding 8 hours of CE will be e-mailed to you.
Your certificate awarding 8hours of CE will be emailed to you.
Help with the course
You can contact the instructor, Dr. David Lukoff, via email or by phone at 888.880.2870.
Software and equipment needed
You only need to have access to a computer with Internet service and a browser such as
Netscape Navigator or Internet Explorer (which you must have to be reading this!)
Refund policy
A full refund is available for any reason until CE is awarded. Contact the instructor, Dr.
David Lukoff, via email or by phone at 888.880.2870.
Difficulties
Can't get to a link
The server for that site may temporarily be experiencing problems. If a link doesn't work,
skip it and come back to it later. The site will probably be back up. Occasionally a site
used in this course may have been taken down. I do check on availability of the sites
regularly. If you have persisting trouble accessing a site, please notify the instructor.
It takes a long time for website to appear
The World Wide Web has also been called the World Wide Wait. If you are using a slow
speed modem (28k or less), or an older computer with a slow processor, web pages can
take one or more minutes to appear. I have the late model Apple G4 Macintosh with a
cable modem, and this combination brings up most web pages in a few seconds. But
cable modems and DSL high speed lines typically cost $40-50 per month, more than
twice what most Internet Service Providers charge. Many universities and libraries
provide high speed access. Web pages do come up sooner when they are re-visited
because parts of the page are saved in a "cache" on your hard disk.
Course Outline and Suggested Times
Introduction to Course 15'
Lesson 1: The Recovery Model 60'
Lesson 2: Consumer Movement 60'
Lesson 3: Mental Health System and Spirituality 60'
Lesson 4: The Spiritual Journey in Mental Disorder 60'
Lesson 5: Genuine Religious Experiences 30'
Lesson 6: Spiritual Support 30'
Lesson 7: Assessing Spirituality 60'
Lesson 8: Online Resources 60'
Quiz, Search Exercises, Evaluation Form 45'
IGL251 LESSON 1
The Recovery Model
Recovery Model
Mental health systems in this country are undergoing a quiet revolution. Former patients
and other advocates are working with mental health providers and government agencies
to incorporate spirituality into mental health care. While the significance of spirituality in
substance abuse treatment has been acknowledged for many years due to widespread
recognition of the therapeutic value of 12-step programs, this is a new development in the
treatment of serious mental disorders such as bipolar disorder and schizophrenia.
What distinguishes the recovery model from prior approaches in the mental health field is
the perspective that people can fully recover from even the most severe forms of mental
disorders. It creates an orientation of hope rather than the "kiss of death" that diagnoses
like schizophrenia once held. One hundred years ago, Emil Kraepelin,MD, identified the
disorder now known as schizophrenia. He described it as dementia praecox, a chronic,
unremitting, gradually deteriorating condition, having a progressive downhill course with
an end state of dementia and incompetence.
However, researchers in in the past two decades in Japan, Germany, Switzerland,
Scotland, France and the USA have established that people diagnosed with schizophrenia
and other serious mental disorders are capable of regaining significant roles in society
and of running their own lives. In fact, most persons with serious mental disorders do
recover. Robert P. Liberman, MD, Professor of Psychiatry at UCLA School of Medicine
notes that there is strong evidence that persons, even with long-term and disabling forms
of schizophrenia, can 'recover,' that is, enjoy lengthy periods of time free of psychotic
symptoms and partake of community life as independent citizens. Daniel Fisher, MD,
PhD,, a former patient, now a psychiatrist, and internationally renowned advocate for the
recovery model, maintains that "Believing you can recover is vital to recovery from
mental illness." Recovery involves self-assessment and personal growth from a prior
baseline, regardless of where that baseline was. Growth may take the overt form of skill
development and resocialization, but it is essentially a spiritual revaluing of oneself, a
gradually developed respect for one's own worth as a human being.Often when people
are healing from an episode of mental disorder, their hopeful beliefs about the future are
intertwined with their spiritual lives, including praying, reading sacred texts, attending
devotional services, and following a spiritual practice.
The belief that one can recover from mental disorder is well established as an important
aspect factor affecting outcome. Daniel Fisher, MD, PhD, a former patient, now a
psychiatrist who is one of the most vocal advocates of the recovery model, has noted that,
Although it is encouraging that Western medicine is beginning to acknowledge the
central role of a positive belief in recovery in the area of physical disorder, it is disturbing
that psychiatry does not see the wisdom of such an attitude for mental disorder. Even
though the weight of personal testimony and epidemiological studies argues that most
people are able to regain a productive role in society and recover from mental disorder,
the mental health field in particular persists in a belief that mental disorder is a permanent
condition.
Daniel Fisher,MD,PhD Believing you can recover is vital to recovery from mental
disorder
People can recover from mental disorder by Daniel Fisher, MD, Ph.D. and Laurie Ahern.
Recovery versus Medical Model
The medical model tends to define recovery in negative terms (e.g., symptoms and
complaints that need to be eliminated, disorders that need to be cured or removed).
Mark Ragins, MD observed that focusing on recovery does discount the seriousness of
the conditions.
For severe mental illness it may seem almost dishonest to talk about recovery. After all,
the conditions are likely to persist, in at least some form, indefinitely. How can someone
recover from an incurable illness? The way out of this dilemma is by realizing that,
whereas the illness is the object of curative treatment efforts, it is the persons themselves
who are the objects of recovery efforts.
Drawing on the 12-step approach to recovery from addictions, Dr. Ragins outlines an
alternative to the medical model approach.
1. Accepting having a chronic, incurable disorder, that is a permanent part of them,
without guilt or shame, without fault or blame.
2. Avoiding complications of the condition (e.g. by staying sober).
3. Participating in an ongoing support system both as a recipient and a provider.
4. Changing many aspects of their lives including emotions, interpersonal relationships,
and spirituality both to accommodate their disorder and grow through overcoming it.
In the recovery model, treatment professionals act as coaches helping to design a
rehabilitation plan which supports the patients' efforts to achieve a series of functional
goals. Their relationship often focuses on motivating and focusing the patient's own
efforts to help themselves. What is important, particularly during the initial stages of
interaction is that professionals afford dignity and respect to those in their care.
REQUIRED QUIZ EXERCISE 1: Problems with Current Model
In Recovery: Changing From A Medical Model To A Psychosocial Rehabilitation Model
Mark Ragins,MD argues that despite clear evidence of the growing efficacy of treatments
and more benign outcomes than traditionally thought, a problem in how recovery is
perceived is due to: a) our conceptual model of treatment and recovery b) the inherent
nature of the conditions c) very few psychiatrists treating people with serious mental
disorders d) all of the above.
Record your answer for later insertion into the Quiz.
.EXERCISE: Listen to Webcast
The Recovery Vision: New paradigm, new questions, new answers.
This webcast from Boston University's Center for Psychiatric Rehabilitation reviews the
empirical knowledge underlying the vision of recovery.
Dr. Courtenay Harding, known for her groundbreaking research in the field of recovery,
reviews the evidence for recovery and its implications.
Dr. William Anthony, one of the pioneers in the field of recovery-oriented rehabilitation,
discusses how recovery research must change the paradigm of the field and the questions
we ask.
Ms. Judi Chamberlin, an internationally known psychiatric survivor and advocate of
individuals with a mental disorder label, discusses the implications of the emergence of
the vision of recovery for the roles of consumers and non-consumers.
Dr. Marianne Farkas, researcher, staff developer, educator and consultant in recovery
oriented psychiatric rehabilitation for over 20 years, addresses how the emergence of a
new paradigm will pose challenges for the development of mental health and
rehabilitation systems.
REQUIRED QUIZ EXERCISE 2: Mental Disorders
According to the first presenter from the World Health Organization in The Recovery
Vision: New paradigm, new questions, new answers, how many people around the world
have a mental disorder a) 100 million b) 200 million c) 500 million d) unknown
Record your answer for later insertion into the Quiz. (If for some reason you have trouble
accessing the webcast, just skip this item by inserting "skip" in the Quiz. You only need
to complete 75% of the quiz items.)
REQUIRED QUIZ EXERCISE 3: Recovery Model
The recovery model a) is based on the medical model b) maintains that full recovery is
possible c) seeks membership in the American Psychiatric Association d) is opposed to
the use of medication
Record your answer for later insertion into the Quiz.
Example of a Recovery Oriented Clinical Program
New Recovery Center at Boston University is an example of a program that has adopted
a recovery model. Their curricular options include such courses as Connectedness: Some
Skills for Spiritual Health, Hatha Yoga, and Intro to the Internet. Matriculated students
take at least two of these semester-long classes, as well as a Recovery Seminar --a guided
exploration of personal recovery that is the center's flagship course.
Recovery has so much to do with quality of life. And that may not necessarily mean
going back to work or going back to school. It may mean developing friendships,
belonging to a church, having a healthy body and a healthy mind. I think we've gotten so
secular in the way we provide services -- focusing on either work or school.
IGL251 LESSON 2
The Consumer Movement
History of the Consumer Movement
There is a growing movement throughout the United States (and the world) of people
calling themselves consumers, survivors, or ex-patients--who have been diagnosed with
mental disorders and are working together to make change in the mental health system
and in society. The consumer movement grew out of the idea that individuals who have
experienced similar problems, life situations, or crises can effectively provide support to
one another. According Sally Clay, one of the leaders of this movement,
The Consumer/Survivor Communities began 25 years ago with the anti-psychiatry
movement. In the 1980's, ex-mental patients began to organize drop-in centers, artistic
endeavors, and businesses. Now hundreds of such groups are flourishing throughout the
country. Our conferences (many sponsored by NIMH) have been attended by thousands
of people. More and more, consumers participate in the rest of the mental health system
as members of policy-making boards and agencies.
When it began, there was an initial hostility toward the mental health system, but the
consumer movement has evolved into a recovery model that encompasses everyone
involved in caring for people with mental disorders.
From around the country, people who had been in treatment for schizophrenia and other
forms of serious mental illness began coming out of the shadows and identifying
ourselves. We were no longer willing to remain hiding, quietly suffering the ridicule and
hostility that too often characterize people's reactions to serious mental illness. Slowly,
we began to organize, forming local, state, and then national organizations for recovering
persons and our allies. We advocated, trying to regain our rights as human beings. For the
most part, the more articulate consumer-advocates felt that professionals, who so readily
dismissed our point-of-view when we had been patients, were not to be trusted. Many of
us felt we could make it "on our own." And why not? All of us had been diagnosed with
having serious mental illnesses...About twelve years ago, however, some consumeradvocates began to suggest that many of us, particularly those who were most disabled,
could not so easily make it "on our own."We suggested that most of us did indeed need
other people: family members, friends, and often the help of experienced mental health
professionals.
Frederick J. Frese
EXERCISE: Listen to Webcast
Vocal and articulate consumer advocate, Sally Zinman, gives a 30-year overview of the
consumer movement at the Summit 2000: The Second National Summit of Mental Health
Consumers and Survivors.
Sally Zinman's keynote speech
The importance of the consumer movement has been recognized and documented by
mainstream mental health, such as in the Surgeon General's report below.
Ex-patients have also written about the struggles and hard won acceptance of the
consumer movement.
The Ex-Patients' Movement: Where We've Been and Where We're Going
By Judi Chamberlin, founder of consumer movement
It's About Time: Discovering, Recovering and Celebrating Consumer/Survivor History
A history by the consumer organization--National Empowerment Center
REQUIRED QUIZ EXERCISE 4: Origins of the Recovery Movement
The recovery movement originally derives from: a) Freud b) Kraepelin c) American
Psychiatric Association d) consumers
Record your answer for later insertion into the Quiz.
Case Example and Advocate
Frederick Frese,PhD is a vocal example of the recovery model. Thirty years ago, he was
locked up in an Ohio psychiatric hospital, dazed and delusional, with paranoid
schizophrenia.
In March of 1966, I was a young Marine Corps security officer. I was responsible for
guarding atomic weapons at a large Naval Air base and had just been selected for
promotion to the rank of Captain. One day, during a particularly stressful period, I made a
"discovery" that certain high-ranking American officials had been hypnotized by our
Communist enemies and were attempting to compromise this country's nuclear
capabilities. Shortly after deciding to reveal my discovery, I found myself locked away in
the seclusion room of the base's psychiatric ward, diagnosed with schizophrenia. This
was the beginning of my official life as a person with serious mental illness. After about
six months I was released from the psychiatric ward at the U.S. Naval Hospital at
Bethesda, Maryland, and from the Marine Corps. During the following ten years I was
repeatedly re-hospitalized and released from a variety of psychiatric facilities around the
country. Most of these hospitalizations were involuntary.
Twelve years later, he had become the chief psychologist for the very mental hospital
system that had confined him. Along the way, despite 10 other hospitalizations, he
married, had four children and earned a master's degree and doctorate. He is currently an
active consumer advocate for the recovery model.
The full story of Frederick J. Frese, PhD
Stigma
The stigmatizing of people with mental disorders has persisted throughout history. It is
manifested by bias, distrust, stereotyping, fear, embarrassment, anger, and/or avoidance.
Stigma leads others to avoid living, socializing or working with, renting to, or employing
people with mental disorders, especially severe disorders such as schizophrenia. It
reduces a person's access to resources and opportunities (e.g., housing, jobs) and leads to
low self-esteem, isolation, and hopelessness. It deters the public from seeking, and
wanting to pay for, care. In its most overt and egregious form, stigma results in outright
discrimination and abuse. More tragically, it deprives people of their dignity and
interferes with their full participation in society.
National Stigma Clearinghouse
This Clearinghouse tracks stigmatizing stereotypes of mental illness in the media and
provides information about stigma to concerned activists. It focuses on inaccurate images
of mental illness in news, advertising, and entertainment media but also include articles
and news on stigma.
REQUIRED QUIZ EXERCISE 5: Stigma in the Media
On the National Stigma Clearinghouse home page, they cite a Robert Wood Johnson
Foundation survey that the public's primary source of information about mental illness is:
a) magazines b) NIMH c) friends d) mass media
Record your answer for later insertion into the Quiz.
The Roots of Stigma
The Surgeon General's Report on Mental Health includes a section on stigmatization of
people with mental disorder.
Online Support Resources
Mutual support is another foundation of the mental health consumer movement.
Throughout the the world, consumers are creating self-help groups (also called support
groups, peer-run services, consumer-run services, and alternative services).
National Mental Health Consumers' Self-help Clearinghouse
This consumer-run national center serves the mental health consumer movement. They
help connect individuals to self-help and advocacy resources, and offer expertise to selfhelp groups and other peer-run services for mental health consumers. Self-help groups
have proven to be effective on a number of levels:
The act of joining together with others who have walked in your shoes enables
individuals to recognize that they are not alone.
Individuals in the mental health system often do not have the support of family and
friends. Self-help groups can provide the support that may be missing from these other
systems.
Self-help groups offer a safe place for self-disclosure.
Self-help groups encourage personal responsibility and control over one's own treatment.
Because group members are actively helping others, they gain a sense of their own
competence.
In contrast to the professional/client relationship, members of self-help groups are equals.
The Clearinghouse has developed the Freedom Self-Advocacy Curriculum, a complete
set of free online training materials for teaching consumers how to advocate for
themselves.
Report from National Summit of Mental Health Consumers and Survivors
This revealing report is based on discussion and a survey of participants about what
recovery means and values, principles, barriers, and priorities in recovery. Many other
reports and presentations from this conference are also online.
IGL251 LESSON 3
Historical Background
Definitions of Spirituality and Religion
The Thesaurus of Psychological Index Terms , which is used to classify articles and
books in the construction the PsycINFO database, defines spirituality as the
Degree of involvement or state of awareness or devotion to a higher being or life
philosophy. Not always related to conventional religious beliefs. (p. 208)
It defines religiosity as the
Degree of one's religious involvement, devotion to religious beliefs, or adherence to
religious observances...term is associated with religious organizations and religious
personnel. (p. 184)
Thus a religion is a dogma, a set of beliefs about the spiritual and a set of practices which
arise out of those beliefs. Spirituality is that realm of human experience which religion
attempts to connect us to. Sometimes it succeeds and sometimes it fails. While spiritual is
not a synonym for religious, a person who has internalized the beliefs and practices of a
religion generally would be considered spiritual.
However, one can be "religious" without being "spiritual"--many members of religious
institutions perform the necessary rituals and accept the creed (at least superficially), but
their ethics, morals, and opportunities for day-to-day practice of their religion do not
match their professed beliefs. (p.6)
Krippner, S. and Welch, P. (1993). Spiritual Dimensions of Healing. New York:
Irvington.
Jerome Stack, a Catholic priest who has worked at Metropolitan State Psychiatric
Hospital in California for 25 years concurs that Spirituality is Not the Same as Religion
Everyone has a spirituality, is that each of us must answer basic questions like ''Who am
I?" or "What is the meaning of my existence?" or "Why am I suffering?" We are all
spiritual, even if we don't belong to a faith group or have a spiritual practice. Spirituality
is characterized by a freely undertaken, mature commitment to religious beliefs and
practices...On the other hand, people can be "religious" without allowing the many
resources of their religious tradition to touch their spirits in a significant way
Theoretical Background
Spirituality plays a major role in the recovery movement, as we shall explore in lessons
4-7. However, the mental health field has a heritage of 100 years of ignoring and
pathologizing spiritual experiences and religion. Freud promoted this view in several of
his works, such as in Future of an Illusion wherein he pathologized religion as:
A system of wishful illusions together with a disavowal of reality, such as we find
nowhere else...but in a state of blissful hallucinatory confusion.
Albert Ellis,PhD is the creator of Rational Emotive Therapy, the forerunner of cognitive
modification approaches now widely used in cognitive-behavioral therapies. In a recent
interview, Ellis stated:
Spirit and soul is horseshit of the worst sort. Obviously there are no fairies, no Santa
Clauses, no spirits. What there is, is human goals and purposes...But a lot of
transcendentalists are utter screwballs.
From a recovery perspective that views spiritual awakening as central to the healing
process, this could be called "Stinking Thinking!"
BF Skinner,PhD, the psychologist who pioneered understanding of behavior modification
principles that are the other half of cognitive-behavioral therapies, did not publish a
single word on the topic of spirituality. He approached humans as stimulus response
boxes with varying behaviors that depend on environmental contingencies. Skinner's
psychology gave no attention to inner experience, which does leave out a lot of what
makes people human beings. However, Skinner's implicit views on religion can be
gleaned from the novel he wrote about a Utopian community, Walden Two.
In this novel, one member describes religion as:
an explanatory fiction, of a miracle-working mind...superstitious behavior perpetuated by
an intermittent reinforcement schedule
New Diagnostic Category: Religious or Spiritual Problem
As noted above, the mental health system has become much more open to recognizing
the importance of spirituality in mental health and in recovery from mental disorders.
One major step was the acceptance a new diagnostic category for Religious or Spiritual
Problems into the Diagnostic and Statistical Manual-IV in 1994.
This category can be used when the focus of clinical attention is a religious or spiritual
problem. Examples include distressing experiences that involve loss or questioning of
faith, problems associated with conversion to a new faith, or questioning of other spiritual
values which may not necessarily be related to an organized church or religious
institution. (p. 685)
The adoption of this new category as a nonpathological category (it is listed as a problem
along with Bereavement) has also led to increased inclusion of religious and spiritual
issues into the curriculum of psychiatry, nursing and mental health training in other
disciplines.
History of the DSM-IV category Religious or Spiritual Problem (V62.89)
REQUIRED QUIZ EXERCISE 6:
Benefits of DSM-IV Religious or Spiritual Problem
Which of these were cited in the proposal described in the History of the DSM-IV
category Religious or Spiritual Problem (V62.89) as benefits of accepting the new
diagnostic category: a) increasing the accuracy of diagnostic assessments when religious
and spiritual issues are involved b) reducing the occurrence of iatrogenic harm from
misdiagnosis of religious and spiritual problems c) improving treatment of such problems
by stimulating clinical research d) all of the above.
Record your answer for later insertion into the Quiz.
REQUIRED QUIZ EXERCISE 7:
DSM-IV Religious or Spiritual Problem
In the DSM-IV, Religious or Spiritual Problem: a) is included in the section on
Adjustment Disorders b) cannot be diagnnosed if there is a co-existing Axis I disorder c)
is included for the first time in the DSM d) is listed as a proposed category for further
consideration.
Record your answer for later insertion into the Quiz.
In some talks I have given, I have used this ancient Scandinavian fairytale as an allegory
of how the mental health field and spirituality need to "get married" and get to know each
other better:
A kingdom was falling into ruin, and an oracle was consulted who determined that the
kingdom could only be saved if the beautiful princess marries a dragon. The reluctant
princess is advised by a wise woman to wear 10 layers of wedding dresses and when they
are alone on their wedding night to ask the dragon to shed a layer of his skin each time
she sheds a dress. When in fact he does so ten times, the dragon stands revealed as a
prince, and the couple and kingdom live happily ever after.
Some would say that mental health and spirituality are already married but need couples
counseling to help them get along better! The development of this course, originating in
presentations to consumers and staff at the San Francisco, Sonoma, and Contra Costa
County Departments of Mental Health, is also an example of the increased receptivity
and sensitivity to spirituality within mental health.
IGL251 LESSON 4
The Spiritual Journey in Mental Disorder
Your life is a sacred journey. And it is about change, growth, discovery, movement,
transformation, continuously expanding your vision of what is possible, stretching your
soul, learning to see clearly and deeply, listening to your intuition, taking courageous
challenges at every step along the way. You are on the path... exactly where you are
meant to be right now.
Caroline Adams
Mental Disorder as a Spiritual Journey
Recovery from a mental disorder is experienced by many people as part of their spiritual
journey. This was eloquently expressed by consumer advocate and Program Director of
the Mental Health Division of Contra Costa County Jay Mahler. During a conversation
with Dan Weisburd, editor of the CAMI Journal, Jay mentioned that he viewed his
disorder as a spiritual journey. When Dan questioned how a devastating mental disorder
could be a spiritual journey, Jay responded:
Regardless of what anyone else chooses to call it, that's what it's been for me. The whole
medical vocabulary puts us in the role of a 'labeled' diagnosed victim. We are the ones
whom they must skillfully attempt to fix, according to them. But as they go through trial
and error, looking to see if anything they have to offer works at all to control your
symptoms, it doesn't take a genius to realize they haven't got the answers. No clue about
cures! And oh boy, those side effects! I don't say medications can't help, or that
treatments won't have value.
But, what I do say is that my being aware that I'm on a spiritual journey empowers me to
deal with the big, human 'spiritual' questions, like: "Dan! Why is this happening to me?
Will I ever be the same again? Is there a place for me in this world? Can my experience
of life be made livable? If I can't be cured can I be recovering. . . even somewhat? Has
my God abandoned me?" Bottom line is, as victim of whatever it is, we who have it have
to wonder whether what remains constitutes a life worth living. That's my spiritual
journey, Dan, that wondering. That's my search. That's something I must do.
REQUIRED QUEST EXERCISE 8: Definitions of the Spiritual Journey
There are many definitions of a spiritual journey. Here are brief excepts from on the
spiritual journey from Thomas Merton, Ignatius Loyola,Teilhard de Chardin,George
Bernard Shaw, John of the Cross. Look over the selections on Readings for the Spiritual
Journey and find one title of a reading that would be appropriate to give to a patient
seeking to explore his or her spiritual life.
Record your answer for later insertion into the Quiz.
Case Examples
Sally Clay describes how her mental disorder was healed by her involvement with
religious practices.
As another example, I will also use my own experience of a spiritual journey in recovery.
Joseph Campbell once said if there was a sign in a hallway that said:
Lecture on God turn right. Meet God turn left
most people would go to the lecture. I was one of those who not only turned left to meet
God but became God--or at least Buddha and Christ. This happened in 1971 when at the
age of 23, I spent two months firmly convinced that I was a reincarnation of both Buddha
and Christ. I spent many sleepless nights while holding conversations with the "spirits" of
eminent thinkers in the social sciences and humanities. I had discussions with
contemporary persons including R. D. Laing, Margaret Mead, and Bob Dylan, as well as
individuals no longer living, such as Rousseau, Freud, and Jung. I also conversed with
my past reincarnations as Buddha and Christ. Based on the wisdom they imparted to me,
I compiled a collection of their teachings into a "Holy Book" that would unite all the
peoples of the world. I began this sacred endeavor by making photocopies of the book
and giving them to my family and friends.
For those two months, my episode met the diagnostic criteria for Acute Schizophrenic
Reaction in the Diagnostic and Statistical Manual-II. In the current DSM-IV, that
experience could be diagnosed as a Hallucinogen Induced Delusional Disorder or a Brief
Psychotic Disorder. As has happened to others (Lukoff and Everest, 1985), I might have
been diagnosed with some other psychotic disorder if I hadn't been supported by friends
while going throught that episode. In 1974 in San Francisco, John Perry, MD, founded
Diabysis treatment center that still serves as a model therapeutic environment for such
crises. Diabysis created a homelike atmosphere where diagnostic labels were not used.
Staff members were selected for their ability to be comfortable with the intensive inner
processes of persons in psychotic states. In this healing environment, patients in such
vulnerable states were able to follow their psyches while being protected from harm.
Most episodes treated at Diabysis lasted 6-8 weeks.
I was fortunate during this period to be supported by friends who took me in for weeks at
a time. They provided sanctuary for me and helped me to get grounded again in the
everyday social world and consensual reality. Without their help, I might have been
confined in a psychiatric hospital, diagnosed with a lifelong psychotic disorder, and
"treated" with medication. Being supported by caring friends is one of the many
experiences in my life for which I am deeply grateful.
However, for a long time after my delusional episode, I kept silent. No one had
responded to me about my gift of the "Holy Book." I was intensely embarrassed about
having believed myself to be such grandiose figures and distributing that book. For years
I talked with absolutely no one about my experience--not my wife, my parents, nor even
my therapist. Yet, like Jay Mahler, I also consider my psychotic episode to be the
beginning of my spiritual journey.
Six years after this episode, I entered Jungian analysis and had a dream in which a large
red book appeared. My analyst asked for my associations to the book. Memories of my
"Holy Book" leaped into my consciousness. I had not discussed my episode with anyone
in seven years, and my heart raced at the prospect of sharing my story with someone in
my own profession. Recognizing therapy as a sacred place where one can safely tell
secrets, I blurted out the details--about believing myself to be a reincarnation of Buddha
and Christ whose mission was to save the world by writing the new "Bible." To show that
I was now a sane member of the psychology profession, I described these as "grandiose
delusions" and "visual hallucinations." At the end of my description, she said,
"Well, I don't think that's craziness. Sounds like something important was happening to
you on a deep level."
She invited me to bring the book to the next session, and I got to tell my story for the first
time.
At the time I assumed the identities of Buddha and Christ, I had very little knowledge
about Buddhism or Christianity. In overcoming my own reluctance to discuss it, I
discovered that the valid spiritual dimensions of my experience could be salvaged
through psychotherapy. Jungian analyst John Perry, MD noted that,
What remains...is an ideal model and a sense of direction which one can use to complete
the transformation through his own purposeful methods.
Visionary Experience and Psychosis
I now view my own experience of having "been" Buddha and Christ as opening me to
ideal models for my spiritual life. As James Hillman (1986) points out, "Recovery means
recovering the divine from within the disorder, seeing that its contents are authentically
religiou. (p. 10). I began my own process of "recovering the divine." I explored
Buddhism, Christianity, and other forms of spirituality as I integrated this episode into
my spiritual journey (see Lukoff, 1990 for a fuller account).
During the past 25 years in my clinical practice as a psychologist at UCLA-NPI,
Camarillo State Hospital, and the San Francisco VA, I have often found myself face-toface with individuals who have had delusions similar to mine. I believe that my ability to
work effectively with those individuals has been aided by being given a rare opportunity
to journey through the complete cycle and phenomenology of a naturally-resolving
psychotic episode. Thus, beyond serving as a spiritual awakening, my journey held
within it the archetypal gift of the Wounded Healer, providng me with the ability to
connect more deeply with persons recovering from episodes of mental disorders.
Based on what I learned from my own psychotic episode, and through my work with
other individuals who had similar episodes, integrating such experiences into a personal
spiritual journey. It involves three phases:
Phase 1: Telling one's Story
Phase 2: Tracing its Symbolic/Spiritual Heritage
Phase 3: Creating a New Personal Mythology
Telling One's Story
This is one of the key steps in integrating an episode of mental disorder into a spiritual
journey. I have published several case studies and found that people in recovery from
mental disorders are not asked to recount or reflect on their experiences. Yet based on my
case studies and contact with people in recovery, telling one's story is the important first
step in the three stages of integrating a mental disorder. It often helps to talk about and
write out a full account of all one has experienced. I did this with patients at Camarillo
State Hospital, UCLA, and the San Francisco VA, and found that even constructing a
simple time line marked with ages and key events serves a therapeutic ordering function.
Then the work of phases 2 and 3 can move toward integrating the experience.
Phase 2: Tracing its Symbolic/Spiritual Heritage
At least of half of people with diagnoses ofdisorders such as bipolar and schizophrenia
have religious delusions and hallucinations.1 In the medical model, further exploration of
such experiences would be unnecessary and could even exacerbate symptoms by
reinforcing his/her "delusional system."
At the age of 23, I spent 2 months firmly convinced that I was a reincarnation of Buddha
and Christ and was on a mission to write a new "Holy Book" that would unite all the
peoples of the world. And I had been raised as a Jew! Jungian analyst John Beebe (1982)
has noted that,
Minimally, the experience of psychotic illness is a call to the Symbolic Quest. Psychotic
illness introduces the individual to themes, conflicts, and resolutions that may be pursued
through the entire religious, spiritual, philosophical and artistic history of humanity. This
is perhaps enough for an event to achieve. (p. 252)
After 7 years, when I did begin to reflect on my experiences, I approached them as
symbolic experiences, I first asked: who were Buddha and Christ? I really had little
knowledge of Christianity or Buddhism at the time I assumed their identity. Like others
whom I have talked with who developed the grandiose delusion that they were god or the
messiah, these stereotypical delusions of grandeur, inflation, and possibly inappropriate
behavior were embarrassing to me later. Yet the treatment literature documents that there
is much therapeutic value in addressing a person's religious delusions [6]. The valid
religious/spiritual dimensions of the experience can be salvaged through psychotherapy.
James Hillman (1986) maintains that,
Recovery means recovering the divine from within the disorder, seeing that its contents
are authentically religious. (p. 10)
Once I was back with both feet on the ground, these experiences gave me great cause to
explore Christianity, Buddhism, and other forms of spirituality. In retrospect, I consider
this period to be my spiritual awakening. In Seduction of Madness, Ed Podvoll, MD,
observed that,
Many who have come through psychotic episodes describe them as the most fantastic
time of their lives.
Much of my work in Jungian analysis consisted of learning how to explore the meaning
of my personal symbols as they appeared in dreams and in my own episode. This search
for meaning by exploring parallels in traditional myths and religious texts has also played
a role in the integration of many of the ex- patients whom I have written about
Myths in Mental Illness Case
Phase 3: Creating a New Personal Mythology
Stanley Krippner, PhD, co-author of The Mythic Path : Discovering the Guiding Stories
of Your Past Creating-A Vision for Your Future defines a personal mythology as
an individual's system of complementary and contradictory personal myths which shape
our expectations, and guide our decisions.
Each of us has a personal mythology--beliefs about life that make up our view of the
world, shape our expectations, and guide our decisions.
Personal myths address life's most important concerns and questions, including
1. Identity (Who am I? Why am I here?)
2. Direction (Where am I going? How do I get there?)
3. Purpose (What am I doing here? Why am I going there? What does it all mean?)
Weaving a mental disorder into a life-affirming personal mythology is essential for
recovery. Unfortunately, many beliefs that people develop around an episode of mental
disorder are dysfunctional myths that emphasize pathological qualities. Since these are
not attuned to the person's actual needs, capacities, or circumstances, such myths do not
serves as constructive guides during recovery.
Experiences of nonconsensual reality, such as dreams and parapsychological events, as
well as the non-ordinary experiences from mental disorders can play a significant role in
shaping positive personal mythologies. All of these involve transcendence of ordinary life
concerns and an experience with a "higher" or "deeper" reality. Awareness of being on a
spiritual journey often becomes the foundation for a new personal mythology that is
growth-enhancing and spiritually supportive.
My personal mythology evolved after discovering the works of Joseph Campbell a few
years after my episode. Campbell identified three stages in the Hero’s Journey. First the
Call, then Initiation, and finally the Return stage, which
requires that the Hero shall now begin the labor of bringing the runes of wisdom, the
Golden Fleece, or his sleeping princess, back into the kingdom of humanity, where the
boon may redound to the renewing of the community, the nation, the planet, or the ten
thousand words. (Campbell, 1949, p.193)
During psychosis, the mind is driven to reveal its deepest, most intimate workings,
images, and structures. Whereas the myths are metaphors for journeys into the psyche,
psychosis is a journey into the psyche. Stories of successful inner voyages of persons in
recovery are boons that communicate the workings of the psyche at the most direct level.
This is why madness is such an important theme in the arts. We have much to learn from
such accounts. I have published several case studies illustrating the powerful dimensions
for both the person on the inner journey and the reader.
My personal boon has involved publications and presentations targeted to increasing the
awareness of mental health professionals about the important role of spirituality in
recovery and in mental health in general. This work contributed to the addition of a new
category to the DSM-IV entitled Religious or Spiritual Problem (V62.89) which I coauthored with Francis Lu,MD and Robert Turner,MD.
Some clinicians have expressed the concern that having patients discuss their delusional
experiences could exacerbate their symptoms by reinforcing them. I was involved in a
study of a holistic health program conducted at state psychiatric hospital in which
participants were encouraged to actively explore their psychotic symptoms. They
participated in in groups such as "Schizophrenia and Growth" which encouraged them to
compare their experiences to those of mystics, Native Amerian vision quests. and
shamanic initiatory crises. Telling their stories did not result in exacerbation of symptoms
(Lukoff et al., 1986).
REQUIRED QUIZ EXERCISE 9:
Exacerbation of Symptoms
In the study A holistic program for chronic schizophrenic patients, the patients in the
holistic health program who were encouraged to explore the growth potential of their
psychotic experiences: a) showed an exacerbation of delusions only b) relapsed less often
c) showed significant decreases in psychopathology d) became more religious.
Record your answer for later insertion into the Quiz.
IGL251 LESSON 5
Genuine Religious Experiences
Genuine Religious Experiences
Jerome Stack, a Catholic Chaplain at Metropolitan State Hospital in Norwalk, California
for 25 years, observed that many people with mental disorders do have genuine religious
experiences:
Many patients over the years have spoken to me of their religious experience and I have
found their stories to be quite genuine, quite believable. Their experience of the divine,
the spiritual, is healthy and life giving. Of course, discernment is important, but it is
important not to presume that certain kinds of religious experience or behavior are simply
"part of the illness."
During manic episodes in particular, people have experiences similar to those of the great
mystics.
There is a general agreement among those who have experienced it, that religious truths
are realized, the religious truths, the ones of the desert fathers and the great mystics. (p.
118)
Ed Podvoll,MD The Seduction of Madness : Revolutionary Insights into the World of
Psychosis and a Compassionate Approach to Recovery at Home
One woman who had been hospitalized for a manic episode told me:
"Since being discharged my appreciation of music, poetry and the Spanish mystics has
been enhanced and I have gained insight into the need of others, which has made the
whole experience worthwhile."
Anton Boisen who was hospitalized for a psychotic episode and then became a minister
and the founder of pastoral counseling, maintained that,
Many of the more serious psychoses are essentially problem solving experiences which
are closely related to certain types of religious experiences.( p. 154)
Exploration of the Inner World : a Study of Mental Disorder and Religious Experience
Sally Clay, an advocate and consultant for the Portland Coalition for the Psychiatrically
Labeled, has written about the important role that religious experiences played in her
recovery following two years of hospitalization while diagnosed with schizophrenia at
the Yale-affiliated Hartford Institute of Living (IOL). While hospitalized, she had a
powerful religious experience which led her to attend religious services.
My recovery had nothing to do with the talk therapy, the drugs, or the electroshock
treatments I had received; more likely, it happened in spite of these things. My recovery
did have something to do with the devotional services I had been attending. At the IOL I
attended both Protestant and Catholic services, and if Jewish or Buddhist services had
been available, I would have gone to them, too. I was cured instantly-healed if you willas a direct result of a spiritual experience.
Many years later Clay went back to the IOL to review her case records, and found herself
described as having "decompensated with grandiose delusions with spiritual
preoccupations." She complains that "Not a single aspect of my spiritual experience at the
IOL was recognized as legitimate; neither the spiritual difficulties nor the healing that
occurred at the end."
Clay is not denying that she had a psychotic disorder at the time, but makes the case that,
in addition to the disabling effects she experienced as part of her illness, there was also a
profound spiritual component which was ignored. She describes how the lack of
sensitivity to the spiritual dimensions of her experience on the part of mental health and
religious professionals was detrimental to her recovery. Nevertheless she has persevered
in her belief that,
For me, becoming "mentally ill" was always a spiritual crisis, and finding a spiritual
model of recovery was a question of life or death. Finally I could admit openly that my
experiences were, and always had been, a spiritual journey -- not sick, shameful, or evil.
The Wounded Prophet by Sally Clay
Thus experiences with religious/spiritual content can be explored, particularly to find
direction for spiritual support. They can also play an important role in helping to redefine
a person's personal mythology as noted in lesson 4.
IGL251 LESSON 6
Spiritual Support
Spiritual Support
Spiritual support involves the degree to which a person experiences a connection to a
higher power (i.e., God or other transcendent force) that is actively supporting,
protecting, guiding, teaching, helping, and healing. For many people, having a
relationship with a higher power is the foundation of their psychological well-being.
Some researchers have suggested that the subjective experience of spiritual support may
form the core of the spirituality-health connection (Mackenzie et al., 2000). The recent
landmark publication Handbook of Religion and Health reviewed 1600 studies, including
hundreds on mental health. One chapter,"Schizophrenia and Other Psychoses,"
summarizes research which indicates that persons with mental disorders utilize their
spiritual resources to improve functioning, reduce isolation, and facilitate healing.
The mental health professions have a long history of ignoring and pathologizing religion
(Lukoff et al., 1992). For instance, Albert Ellis asserts, "The less religious [patients] are,
the more emotionally healthy they will tend to be" (Ellis, 1980, p. 637). But the data
show otherwise: religion is overwhelmingly associated with positive mental health.
Because individuals seek meaning when experiencing severe illnesses, and spirituality is
an important coping mechanism, promoting religious and spiritual beliefs and practices is
highly appropriate. Mental health professionals can provide spiritual support to people
coping with mental disorders. By devoting some therapy time to exploring spiritual issues
and asking questions to discover a deeper meaning in life, they can help to create the
spirituality-health connection.
Spiritual support can include:
Educating the client about recovery as a spiritual journey with a potentially positive
outcome.
Encouraging the client's involvement with a spiritual path or religious community that is
consistent with their experiences and values.
Encouraging the client to seek support and guidance from credible and appropriate
religious or spiritual leaders.
Encouraging the client to engage in religious and spiritual practices consistent with their
beliefs (e.g., prayer, meditation, reading spiritual books, acts of worship, ritual,
forgiveness and service). At times, this might include engaging in a practice together with
the client such as meditation, silence, prayer, or singing.
Modeling one's own spirituality (when appropriate), including a sense of spiritual
purpose and meaning, along with hope and faith in something transcendent.
Mental health programs can, through their structures and culture, create environments
that promote this spiritual work. New Recovery Center at Boston University is an
example of a program that has adopted a recovery model incorporating a spiritual
component. Curricular options include such courses as Connectedness: Some Skills for
Spiritual Health, Hatha Yoga, and a Recovery Seminar. This guided exploration of
personal recovery is the center's flagship course.
People recovering from mental disorders have rich opportunities for spiritual growth,
along with challenges to its expression and development. They will find much needed
support for the task when they are clinically guided to explore their spiritual lives. Thus
directed, they can begin to create a positive health-promoting outcome for their spiritual
journey in recovery.
QUIZ EXERCISE 10: Spirituality in Healthcare Organizations
In Spirituality and healthcare organizations the authors suggest that healthcare
organizations implementing a spiritual component in programming, should a) make sure
views of nonreligious staff and patients are respected b) provide clear guidelines for the
extent and nature of spiritual support for patients c) elicit input from all staff to identify
common values d) all of the above
Record your answer for later insertion into the Quiz.
Psychiatrically Hospitalized Patients
Studies have found that hospitalized psychiatric patients are as religious as the general
population and they turn more to religion during such crises In The religious needs and
resources of psychiatric inpatients the authors found that 88% of the psychiatric patients
reported three or more current religious needs. Psychiatric patients had lower spiritual
well-being scores and were less likely to have talked with their clergy. They concluded
that religion is important for the psychiatric patients, but they may need assistance to find
resources to address their religious needs.
QUIZ EXERCISE 11: Religious Needs of Hospitalized Patients
In The religious needs and resources of psychiatric inpatients the authors compared
patients in a medical/surgery and a psychiatric unit, and found: a) greater religious needs
in the psychiatric patients b) no differences in religious resources c) no differences in
religious needs between the two patient groups, but significant differences in religious
resources d) greater religious needs in the psychiatric patients.
Record your answer for later insertion into the Quiz.
Another form of spiritual support is to address dysfunctional beliefs about their disorder
that many patients hold. One study of 52 psychiatric inpatients found that 23% believed
that sin-related factors, such as sinful thoughts or acts, are related to the development of
their illness.
Sheehan W, Kroll J Psychiatric patients' belief in general health factors and sin as causes
of illness. Am J Psychiatry 1990 Jan;147(1):112-3
This is clearly a guilt-inducing belief for which there is no evidence, and the vast
majority of religious professionals would challenge. When I was a psychologist at
Camarillo State Hospital, I collaborated with a rabbi who led groups for patients, and this
was one of the beliefs he regularly encountered. He made a point of disputing such
assertions when they were voiced, using both old and new testament citations.
But in general, intensity of religious beliefs is not associated with psychopathology
Patients who have little or no religious commitment are just as likely to have depression,
anxiety or other personality disorders as patients with higher levels of religious
commitment. In several studies, being highly religious is not a risk factor for
psychopathology, as has been often taught in mental health training programs. The
authors of one study concluded:
The notion that religion exerts a negative influence on mental health in patients was not
generally supported by our findings. The primary factor in patients who display religious
conflicts and anxieties seems not to be the degree of religious commitment itself, but
rather their underlying psychological disease.
Psychopathology and religious commitment--a controlled study. Pfeifer S, Waelty U
Psychopathology 1995;28(2):70-7
IGL251 LESSON 7
Assessing Spirituality
Spiritual Assessment Defined
Spiritual assessment is the process by which health care providers can identify a patient's
spiritual needs pertaining to their mental health care. The determination of spiritual needs
and resources, evaluation of the impact of beliefs on healthcare outcomes and decisions,
and discovery of barriers to using spiritual resources are all outcomes of a thorough
spiritual assessment. At St. Elizabeth's Hospital in Washington, D.C., the Chaplain
Program, headed by Clark Aist, conducts a "Spiritual Needs Assessment" on each
inpatient, concluding with a treatment plan that identifies religious/ spiritual needs and
problems, role of pastoral intervention, and religious/spiritual activities recommended.
When I started the year-long human sexuality training program at the UCLA
Neuropsychiatric Institute, we were given the assignment to pair up and interview each
other about our sexual histories--our first sexual memories, wet dreams, masturbation,
petting, intercourse, sexual problems etc. After all, if we were going to ask our patients
about their sexual experiences and problems, we needed to be comfortable listening to
and talking openly about sexuality. Although we were all licensed mental health
professionals, we had not been trained to talk with patients about their sexual functioning
or problems, and this exercise was a great way to desensitize us (as in "systematic
desensitization") to the topic of sexuality.
I have found the same approach to be helpful with the topic of spirituality, and have
developed the following interview as a desensitization exercise for training mental health
professionals to conduct assessments of spirituality. I have used it at numerous
workshops and conference, and in my experience, most mental heath professionals have
an untapped reservoir of spiritual depth that they have not had permission to bring it into
their clinical practices. I have also used this assessment with patients in both the dual
diagnosis and chronic pain groups I have led at the San Francisco VA.
The interview below was developed after consulting many assessment instruments
published in books and articles, and disseminated at conference presentations. It can
usually be completed in 10 minutes.
Spiritual Assessment Interview
A. RELIGIOUS BACKGROUND AND BELIEFS
1. What religion did your family practice when you were growing up?
2. How religious were your parents?
3. Do you practice a religion currently?
4. Do you believe in God or a higher power?
5. What have been important experiences and thoughts about God/Higher Power?
6. How would you describe God/Higher Power? personal or impersonal? loving or stern?
B. SPIRITUAL MEANING AND VALUES
1. Do you follow any spiritual path or practice (e.g., meditation, yoga, chanting)?
2. What significant spiritual experiences have you had (e.g., mystical experience, neardeath experience, 12-step spirituality, drug-induced, dreams)?
C. PRAYER EXPERIENCES
1. Do you pray? When? In what way(s)?
2. How has prayer worked in your life?
3. Have your prayers been answered?
FICA
Another approach to spiritual assessment uses the acronym FICA.
F: FAITH AND BELIEFS
1) What are your spiritual or religious beliefs?
2) Do you consider yourself spiritual or religious?
3) What things do you believe in that give meaning to your life?
I: IMPORTANCE AND INFLUENCE
1) Is it important in your life?
2) How does it affect how you view your problems?
3) How have your religion/spirituality influenced your behavior and mood during this
illness?
4) What role might your religion/spirituality play in resolving your problems?
C: COMMUNITY
1) Are you part of a spiritual or religious community?
2) Is this supportive to you and how?
3) Is there a person or group of people you really love or who are really important to you?
A: ADDRESS
1) How would you like me to address these issues in your treatment?
FICA is described in more detail at the National Health care Research Institute web site.
Christina M. Puchalski, M.D. has published online 5 cases in which the FICA Spiritual
Assessment tool has been applied.
REQUIRED QUIZ EXERCISE 12: FICA Spiritual Assessment
In the 5 cases in which the FICA Spiritual Assessment tool has been applied, the faith
category includes such examples as: a) neither beliefs nor faith b) naturalist c) Buddhist
d) all of the above.
Record your answer for later insertion into the Quiz.
HOPE Assessment
Yet another approach to spiritual assessment is entitled HOPE, where
H--sources of hope, strength, comfort, meaning, peace, love and connection
O--the role of organized religion for the patient
P--personal spirituality and practices
E--effects on medical care and end-of-life decisions
Questions used in this approach are on included in this article:
Spirituality and Medical Practice: Using the HOPE Questions as a Practical Tool for
Spiritual Assessment GOWRI ANANDARAJAH, M.D., and ELLEN HIGHT, M.D.,
M.P.H American Family Physician
EXERCISE: Take 10 minutes and answer the questions for the FICA or the Religious and
Spiritual History.
IGL251 LESSON 8
Online Resources
Case Based Tour
EXERCISE: Case Based Tour of Online Resources This is an Internet Guided tour of
web sites I have found in searches to further explore the meaning of my episode. CaseBased Tour
Self-Help Resources
Early Psychosis Training Pack
This material has been developed to provide information about preventive intervention in
early psychosis - a relatively new area to many of those involved in the care and
management of people with psychotic disorders. The pack consists of a series of ten
modules covering all aspects of preventive intervention in early psychosis, from
recognition of incipient psychosis to psychosocial and medical interventions and ongoing
management.
Thrivenet
Resource for learning about resilience, thriving, and how to gain strength from adversity.
Includes article form psychologist Al Siebert, PhD, and stories of survivors.
Successful Schizophrenia Exchange
National Mental Health Consumers' Self-Help Clearinghouse
A consumer-run national center serving the mental health consumer movement.
Recovery, Inc.
Recovery Inc. is a mental health self-help program based on the work of Abraham A.
Low, MD. They are nonprofit, nonsectarian and completely member managed. Recovery,
Inc. has been active since 1937 and has groups meeting every week around the world.
Articles for professionals
Sally Clay's Recovery and Advocacy links
Schizophrenia.com
A not-for profit information, support, and education center for people diagnosed with
schizophrenia,parents, spouses, offspring. Contains information on Causes, Diagnosis,
Medications, Success Stories, Support Groups.
Recovery, Self-Help and Empowerment articles from the National Empowerment Center
It's About Time: Discovering, Recovering and Celebrating Consumer/Survivor History
Support Coalition International
A consumer group focused on human rights in the mental health system, and publisher of
Mind Freedom, a magazine devoted to this issue.
Coping with Schizophrenia
Frederick J. Frese,PhD describes Twelve Aspects Of Coping For Persons With
Schizophrenia, including denial, delusional thinking, medications, social deficits,
consumer groups and self-help.
Recovery Model in Mental Health
People can recover from mental illness Daniel Fisher, M.D., Ph.D. and Laurie Ahern
wakenings and Recovery - Learning the Beat of a Different Drummer by Harriet P.
Lefley, Ph.D.
Recovery: Changing From A Medical Model To A Psychosocial Rehabilitation Mode by
Mark Ragins,MD
MENTAL DISORDERS ARE NOT DISEASES by Thomas S. Szasz, MD
Peter R. Breggin, MD
has written extensively about the overuse and side effects of psychiatric medications.
New Recovery Center
Article from Boston University web site about a program that offers holistic approach to
mental disorders.
Schizophrenia: Wellness Center
Medscape maintains this site with the latest psychiatric and medical news and
information on schizophrenia.
2 web casts
Religious and Spiritual Resources
FaithNet NAMI
The Broken Covenant
Reverend Jerome Stack, C.P.P.S., Department of Mental Health, Metropolitan State
Hospital, Norwalk, CA
SPIRITUALITY IS NOT THE SAME AS RELIGION by Jerome Stack
Readings for the Spiritual Journey
List 6
Spiritual Emergencies Course
A free course on spiritual crises that can present as or overlap with mental disorders
Discussion Lists
Schizoph Send mail to [email protected] and include in the body of message only
the following: sub schizoph yourfirstname yourlastname Ê
Newsgroups
alt.support.schizophrenia
alt.support.schizophrenia
REQUIRED QUIZ EXERCISE 13: Search about Shintoism
A Japanese patient raised as a Christian wants to find out more about shintoism to see if
that would be compatible with his spiritual path. He has asked you to help him find the
sacred book for shintoism. You go to BeliefNet's section on Religions and on the left side
is a link to Shinto. You click on that and find Shintoism: 1) has no comprehensive canon
of scripture, 2) uses the Old Testament, 3) uses the Tao Te Ching, 4) uses secret
teachings not available in printed form.
Record your answer for later insertion into the Quiz.
Online Case Library
REQUIRED QUEST EXERCISE 14:Search Medline for Recovery Articles
Search Medline for articles on "recovery and mental illness". Note that when you find an
article you are particularly interested in, you can click on Related Articles on the right
side to view other abstracts on the same topic. Insert the title of one article.
Record your answer for later insertion into the Quiz.
REQUIRED QUEST EXERCISE 15: Search Medline for Spirituality Articles
Search Medline for articles on "recovery and spirituality". Note that when you find an
article on mental disorders you are particularly interested in, you can click on Related
Articles on the right side to view other abstracts on the same topic. Insert the title of one
article.
Record your answer for later insertion into the Quiz.